Prioritizing Citizens Demand to Improve Quality of Care in India

Presentation at the Global Maternal Newborn Health Conference, October 19, 2015

Background: India has made progress in reducing maternal mortality by increasing access to maternal health care. Institutional delivery rate continues to increase but will be jeopardized if the quality of care received at health facilities is not improved. Quality of care is not only important to ensure improved maternal health outcomes, but is also an important determinant of whether and in which facility women choose to deliver. Women typically rely on word of mouth to determine where to seek maternal health care. WRA India saw a need to identify and promote strategies that are rooted in linking women in the process of improving quality of care.

Methodology: A multi-stakeholder consensus process was adopted to develop a prioritized list of indicators for quality of care from the woman’s perspective. A first of its kind crowdsourcing platform, free and accessible from any mobile phone, was developed to both “push“ out information to women seeking maternal care on what constitutes quality maternal health care as well as “pull” in women’s ratings of the quality of care received by them. A pilot was conducted with 400 pregnant/lactating women across 20 villages in Jharkhand, India, to test the feasibility of the interactive voice response (IVR) platform.

Results: Results demonstrate that IVR platform is a viable medium for rural, illiterate women to engage with, learn from, and provide feedback on quality of care received. Women indicated that health facility quality of care ratings would influence their future choice of facility. Facility administrators and government officials were receptive to receiving women’s feedback to improve care.

Conclusion: The model has the potential to influence users understanding of quality of care and their entitlements and build a rich database of community-generated information. Thereby empowering women to demand quality of care and push service providers to offer quality care.